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General NPI Number Information
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NPI Number | 1275538274
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Entity Type | Organization
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Legal Business Name | ASSOCIATES IN MEDICAL AND SURGICAL DERMATOLOGY, P.A.
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Dates
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Enumeration Date | 06/16/2005
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 9125 CORSEA DEL FONTANA WAY # 100
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City | NAPLES
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State | FL
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Zip | 34109-4396
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Country | US
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Telephone | 239-598-4004
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Fax | 239-598-4713
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Provider Business Mailing Address
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Address Line | 9125 CORSEA DEL FONTANA WAY # 100
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City | NAPLES
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State | FL
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Zip | 34109-4396
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Country | US
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Telephone | 239-598-4004
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Fax | 239-598-4713
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. DAVID SETH GOODMAN
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Credential | M.D.
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Telephone | 239-598-4004
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 173000000X
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Taxonomy Name | Legal Medicine
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License Number |
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License Number State |
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